PREV MED PEARLS Flashcards
Aprropriate measure of central tendency in qualitative data such as gender, religion or nationality
MODE
Average; sum of observations divided by the number of observations
MEAN
Middle observation in a series of ordered observations eg. 50th percentile
MEDIAN
Observation that occurs with the greatest frequency
MODE
Branch of medicine that deals with study of causes, distribution and control of disease in populations
EPIDEMIOLOGY
Distribution and determination of frequency of disease in humans
EPIDEMIOLOGY
Samplin unit in epidemiologic studies in the identification of causal factors
GROUP of INDIVIDUALS
Ultimate goal of an epidemiologic investigation
INSTITUTE CURATIVE, PREVENTIVE and CONTROL MEASURES to AVOID MORE CASES
Studies both the DISTRIBUTION OF DISEASES in human populations and the DETERMINANTS OF THE OBSERVED DISTRIBUTION; began as study of infectious diseases; expanded to include the study of Chronic Disease, Organization of Health Care, Delivery of Health Care and Occupational and Environmental Health
EPIDEMIOLOGY
Study of distribution of diseases in animals
EPIZOOTIOLOGY
SLOW and PROGRESSIVE CHANGE in the antigenic composition of microorganisms; alters the immunological responses of individuals and a populations susceptibility to that microorganism
ANTIGENIC DRIFT
SUDDEN CHANGE in the molecular structure of a microorganism and produces new strain; results in little or no acquired immunity to these new strains and is the explanation for new epidemics or pandemics
ANTIGENIC SHIFT
Result in influenza cases with high case fatality rates seen previously with this strain
VACCINE FAILURE
Decrease the probability that a susceptible person would come into contact with an infected person; would not affect the clinical presentation of those infected
HERD IMMUNITY
No cases on record,disease absent from beginning, disease has been eradicated
ABSENCE OF DISEASE
Occurrence of few and unrelated cases
SPORADIC
Constant occurrence
ENDEMIC
Occurrence of a number of cases of disease in excess of normal occurrence of expectancy
EPIDEMIC
Epidemic involving many countries
PANDEMIC
Association between Low Birth Weight and Maternal Smoking during pregnancy studies by obtaining smoking histories from women at the time of the prenatal visit and subsequently correlated birth weight with smoking histories
PROSPECTIVE COHORT
Large number of persons have acquired mild symptoms of a disease despite being vaccinated for the appropriate strain being cultured and finding out it’s the same as that incorporated into the trivalent vaccine administered throughout the world, also noting that the strain had high case fatality rate in previous epidemics in China, where most new strains are isolated and identified for vaccine preparations
ANTIGENIC DRIFT
Recommended study for finding out the cause of a rare form of a disease, with access to the largest database of cases about the disease but there is scarcity of time and resources
CASE CONTROL
In finding out the cause of lung cancer, patients who had the disease are matched with controls by age, sex, place of residence, and social class then the frequency of cigarette smoking are compared in the 2 groups
CASE CONTROL
A research team wishes to investigate a possible association between smokeless tobacco and oral lesions among professional baseball players, they ask each player about current and past use of smokeless tobacco, cigarettes and alcohol then a dentist notes the type and extent of lesions in the mouth
CROSS SECTIONAL
Subjects are categorized on the basis of exposure or lack of exposure to a risk factor, then are followed to determine if a particular outcome develops
PROSPECTIVE COHORT
Groups of subjects who are followed forward in time to see which ones develop the outcome
COHORT
Prospective studies in which an intervention is applied
CLINICAL TRIALS
study of the relationship between low birth weights and maternal smoking, infants are selected on the basis of low birth weight and normal birth weight and then the frequency of maternal smoking would be compared in the two groups
RETROSPECTIVE CASE CONTROL
Exposure and outcome are measure at the same point in time
CROSS SECTIONAL
Clinical characteristic or outcome from a SINGLE clinical subject or event (n=1); No control; Eg. A 23 yr old man with MDRTB
CASE REPORT
Clinical characteristic or outcome from a GROUP of clinical subjects or events (n>1); No controls; Eg. Patients in a local hospital with MDRTB
CASE SERIES
PREVALENCE STUDY; determines in each member of the population the PRESENCE OR ABSENCE OF A DISEASE and other variables AT ONE POINT IN TIME; assesses the association of risk factor and disease; CAUSALITY CANNOT USUALLY BE DETERMINED; No controls; Eg. Who in the community NOW has MDRTB?
CROSS SECTIONAL
Identifies a group of people with the disease (CASE) and compares them with a suitable comparison group without the disease (CONTROL); retrospective; assesses many risk factors for disease; can help determine causal relationships; weakest because outcome has already happened; cannot assess incidence and prevalence of disease; VERY USEFUL FOR STUDYING CONDITIONS WITH VERY LOW INCIDENCE OR PREVALENCE; Cases vs Controls; Eg. Comparing cases of MDRTB with cases of nonresistant TB
CASE CONTROL
Population group exposed to a risk factor is followed over time compared with a group not exposed to the risk factors; outcome is disease incidence in each group; prospective; can determine incidence and causal relationships if there is statistical association between risk factor and disease; Population at risk vs Population not at risk; Eg. Following a prison inmate population and marking the development of MDRTB
COHORT
Notification of health providers concerning increased cases, education of the public concerning self- protective measures, control of the snail host, Oncomelania quadrasi
PUBLIC HEALTH POLICIES for PREVENTION and CONTROL
Methods used are public education, surveillance systems, environmental control and dissemination of information to health providers; Individual treatment is traditionally left to individual practitioners
PUBLIC HEALTH
Number of true positives divided by number of all people with disease; Positive In Disease; used to RULE OUT a disease; high factor is desirable for a Screening test, to rule out
SENSITIVITY
Number of true negatives divided by the number of all people without the disease; Negative In Health; used to RULE IN; high factor is desirable for a Confirmatory test, to rule in
SPECIFICITY
Total number of cases in a population at a given time
PREVALENCE
Number of new cases in a population per unit time; NEW cases
INCIDENCE
Number of true positives divided by the number of people who tested positive for the disease; probability of having a condition, given a positive test
POSITIVE PREDICTIVE VALUE
Number of true negatives divided by the number of people who tested negative for the disease; the probability of not having a condition, given a negative test
NEGATIVE PREDICTIVE VALUE
Dependent on the prevalence of a diseasel the higher the prevalence of a disease, the higher the positive aspect of the test
PREDICTIVE VALUE
Absence of vascular calcification in an adult suggests that severe valvular aortic stenosis is not present, meaning the valvular calcification is
SENSITIVE
one that is positive in most patient with the disease; if absence of a charateristic rules out a disease, then the test in sensitive, hardly anyone with the disease has a negative test
SENSITIVE TEST
In country A, there are 35 new cases of breast cancer per 100,000 adult women per year; in country B, the number is 90 per 100,000. What is the explanation?
WOMEN IN COUNTRY A ARE YOUNGER
Most important risk factor for the development of breast cancer, like most cancers
AGE
May have a protective effect on breast cancer but nowhere near the magnitude of the effect of age
NURSING
NOT a major risk factor for breast cancer
CIGARETTE SMOKING
Important cause of morbidity in Western world but mortality is decreasing; boys and girls are nearly equally affecter; most common in 2nd or 3rd decades of life; during pregnancy, displacement during pregnancy by the uterus may make diagnosis difficult
APPENDICITIS
Bacteria involved in nosocomial infections are transmitted most often via
DIRECT HAND CONTACT
Highly decrease transmission of nosocomial pathogens
METICULOUS HANDWASHING
Most common site of nosocomial infections
GENITOURINARY TRACT
Accounts for 35% of all nosocomial infections; 70-80% are related to catheters and urinary tract manipulations
UTI > SSI > RTI > SEPTICEMIA
Associated with acute episodes of asthma
EMOTIONAL STRESS, ELEVATED OZONE CONCENTRATIONS, URTI
Dust, animal dander, RTI’s, Ozone pollution, Aspirin, Emotional factors
TRIGGERS FOR ACUTE EPISODE OF ASTHMA
Methylxanthine related to Theophylline, a low- potency bronchodilator
CAFFEINE
Body fat of >30% of total body mass in Women, >25% in Men; major risk factor for DM2, relatively unimportant risk for CHD except at extremes of weight distribution; both behavioral and genetic factors contribute; arthritis is common; highly associated with Hypertension
OBESITY
most commonly caused by pernicious anemia in temperate climates sec to gastric mucosal atrophy sec to autoimmune reaction against parietal cells; increased risk in patients with a personal or family history of autoimmune disease; Diphyllobothrium latum, a fish tape worm; tropical sprue; RARELY with NONTROPICAL SPRUE
COBALAMIN (VITAMIN B12) DEFICIENCY
60 year old most likely to have a stroke within a year
MAN WITH HYPERTENSION
Major risk factor for Stroke; Other risk factors include smoking, vascular disease, TIA and DM
HYPERTENSION
Increased incidence of Cholelithiasis
DIABETES, CHRONIC HEMOLYTIC DYSCRASIA, FEMALE GENDER
Extremely common in 20% women and 8% men above 40; although mostly contains cholesterol but hypercholesterolemia is not associated with an increased risk; increased risk in Diabetics, as well as morbidity and mortality associated with the disease, calcium bilirubinate formation sec to chronic hemolysis; other risk factors include age, obesity, chronic biliary infection
GALLSTONES
Cancer with Increasing age- adjusted mortality in the past 25 years
LUNG
Type of cancer most frequently result to gynecologic cancer deaths
OVARIAN (End Stage)
Cancer by which risk is reduced by use of oral contraceptives having most impact on gynecological mortality
OVARIAN
Most important risk factor for developing Cervical Cancer
HUMAN PAPILLOMA VIRUS TYPE 16 (16, 18, 31, 45, 51-53)
Cancer associated with increased risk due to cigarette smoking
LIVER
Most common risk factor for Liver Cancer worldwide
HEPA B VIRUS or HEPA C VIRUS INFECTION
Most common site for cancer in females in developing countries
BREAST
Chronic exposure result to development of neuropathic symptoms
MERCURY, LEAD, ARSENIC
Intention tremor, delirium; MAD as HATTER in felt hat manufacturing
ORGANIC MERCURY
Peripheral neuropathy and ataxia; irreversible CNS defect in children
LEAD
Similar to neuropathy seen in pernicious anemia
NITROUS OXIDE
Delirium, Coma
ARSENIC
Irritation of mucous membrane
SULFUR DIOXIDE
Usually associated with pneumoconiosis
DUST PARTICLES
Fibrosing lung disease usually due to chronic occupational exposure to AIR with PARTICULATE MATTER, Eg. Anthracosis, Silicosis, Asbestosis, Berylliosis, Farmer’s Lung, Byssinosis
PNEUMOCONIOSIS
Cause acute bronchospasm or exacerbate chronic bronchitis and emphysema
SULFUR DIOXIDES, NITROGEN OXIDES, OIL FUMES & CIGARETTE SMOKING
Battery makers, gasoline boys, solderers are workers associated with occupational exposure
LEAD
Most serious manifestation of lead intoxication
CEREBRAL EDEMA
Major environmental source of lead absorbed in the human bloodstream in adults
AIR
Bulag (Cataracts, Bingi (Sensorineural deafness), Bobo (mental retardation), Butas ang puso (PDA), Blueberry baby
CONGENITAL RUBELLA SYNDROME
Most prevalent mental health disorder in young children
BEHAVIORAL PROBLEMS (10% of children)
Alcoholics, found in all social classes, likely women than men, likely been abused as children
CHIL ABUSERS
Increased risk are associated with thrombophlebitis, Carbohydrate intolerance, high levels of high- density lipoproteins
ORAL CONTRACEPTIVE AGENTS
Testicular atrophy, aggressive behavior, cholestasis among adolescents are associated with
ANABOLIC STEROIDS
Time from infection of TB to (+) Tuberculin ST
2-8 WEEKS
Dengue, yellow fever, chicken pox
VIRAL INFECTIONS
Scabies, Measles, Shigellosis
PERSON to PERSON SPREAD
Rabies, Psittacosis, Salmonellosis
ZOONOSES
Walking pneumonia, Brucella, Strep throat
BACTERIAL INFECTIONS
Neutralizing antibody develops in 95% of people after an attack of Measles; ability of microbe or purified antigen to INDUCE SPECIFIC ANTIBODY PRODUCTION in a host as a result of infection or immunization
IMMUNOGENICITY
Febrile respiratory tract disease develops in approximately 80% of children infected with influenza; capacity of microbe to CAUSE SYMPTOMATIC ILLNESS in an infected host
PATHOGENICITY
Death occurs in approximately 20% of cases of pneumococcal meningitis; Severity of illness produced by a microbe measured by the percentage of SEVERE or FATAL CASES
VIRULENCE
Approximately 50% of household contacts of a child who has a common cold become infected; ability of a microbe to SPREAD in a population of exposed susceptible persons
CONTAGIOUSNESS
Time interval between entry of an infectious agent into a host and the onset of symptoms
INCUBATION PERIOD
Considered the single most important preventive measure against disease
WATER SANITATION
Meningitis, epiglottitis, pneumonia, periorbital or facial cellulitis (Mainly in children)
HAEMOPHILUS INFLUENZA TYPE B
2nd most common cause of AOM in children, next to Pneumococcus but most cases are due to non- typable strains rather than type B (BAD)
HAEMOPHILUS INFLUENZA
Universal prenatal screening test recommended for pregnant women based on evidence that early treatment of the neonate and subsequent vaccination is 85-90% effective in preventing development of chronic carrier state
HEPATITIS B SURFACE ANTIGEN
Prenatal screening for identified high risk
HIV SCREENING
Prenatal screening for people at high risk for Thalassemia or Sickle Cell Anemia
ELECTROPHORESIS
Prenatal screening test for women with uncertain menstrual histories or risk of IUGR
ULTRASOUND
Approved in June 2011, a mandatory basic immunization shall be given for free at any government hospital or health center to infants and children up to 5 years of age covering TB, DPT, Polio, Measles, Mumps, Rubella or German Measles, Hepa B, HIB, and others determined by DOH
RA 10152: MANDATORY INFANTS AND CHILDREN HEALTH IMMUNIZATION ACT OF 2011
Major mean of prevention of this disease is through passive immunization (Immune Serum Globulin)
VIRAL HEPATITIS TYPE A
Given to pregnant women if Tetracycline is contraindicated
AZITHROMYCIN
Pevention of Brucellosis depends on preparation of dairy products derived from Goats, Sheep or Cattle
PASTEURIZATION
No vaccines for human use is available, person to person transmission does not occur, so treatment of individuals will not control spread
BRUCELLOSIS
Effective means of preventing Trichinosis in humans
PROHIBITING THE MARKETING OF GARBAGE-FED HOGS
Ensuring that all garbage and offal fed to hogs are heat- treated to destroy cysts or preferably devoid of animal meat; PROHIBITION OF MARKETING OF GARBAGE-FED HOGS IS EASIER TO ENFORCE THAN INSPECTION TO ENSURE THAT ALL GARBAGE IS PROPERLY COOKED; Thorough cooking at temperature at least 77oC (171oF) to destroy cysts; Freezing
CONTROL of TRICHINELLA SPIRALIS
Hypoalbuminemia, Edema, Ulcerated Dermopathy are characteristic signs of
KWASHIORKOR
Petechiae, sore gums, hematuria, and bone or joint pain
VITAMIN C DEFICIENCY
Dermatitis, Diarrhea, Delirium
NIACIN DEFICIENCY (VITAMIN B3)
Edema, Neuropathy and Myocardial Failure
THIAMINE (VITAMIN B1) DEFICIENCY
XEROSIS CONJUNCTIVAE, HYPERKERATOSIS, and KERATOMALACIA
VITAMIN A DEFICIENCY
Poor mineralization of bones and teeth; Osteoporosis
CALCIUM DEFICIENCY
Nausea, Diarrhea, Muscle Cramps, Dehydration
SODIUM DEFICIENCY
Tendency to have dental Carries
FLUORINE DEFICIENCY
Dwarfism, Hepatosplenomegaly, Poor Wound Healing
ZINC DEFICIENCY
Lung Fluke Disease
CRAB (SUNDATHILPHUSA)
Schistosomiasis
SNAIL (ONCOMELANIA)
Toxocariasis
DOG
Cysticercosis
SWINE
Absolute indication for Papaniculaou Test
ALL SEXUALLY ACTIVE TEENAGE GIRLS
Group of people who are related to each other either biologically, emotionally or legally; (by affinity): group of people related by blood, marriage or adoption who live together in one household; (By structure, function, composition and affection): small social system made up of individuals related to each other by reason of strong reciprocal affections and loyalties and comprising a permanent household (or cluster of household) that persists over years and decades
FAMILY
Composed of parents and dependent children, has separate dwelling, economically independent
NUCLEAR FAMILY
Composed of parents, children and relatives; aggregate of families or part of families from 2 or more generations occupying a single or adjacent dwellings
EXTENDED FAMILY
Composed of children
SINGLE PARENT FAMILY
Includes step- parents and step- children; due to divorce/ annulment with remarriage
BLENDED FAMILY
Composed of different families formed for specific ideological or societal purposes, frequently considered as alternative lifestyle for people who feel alienated from a predominantly economically oriented society, Eg. Amish community
COMMUNAL or CORPORATE FAMILY
Represents a composite of the individual developmental changes of family members; presents a cyclic development of the evolving family unit; shows the evolution of the marital relationship
FAMILY LIFE CYCLE
Leaving home, accepting emotional and financial responsibility for self, differentiation of self in relation to family of origin
UNATTACHED YOUNG ADULT
Joining of families through marriage, commitment to new system, realignment of relationships with extended families and friends to include spouse
NEWLY MARRIED COUPLE
Accepting new members into the marriage and extended family, joining in child rearing, financial and household task
FAMILY with YOUNG CHILDREN
Increasing flexibilities to include children’s independence and grandparents’ frailties, refocus on midlife marital and career issues
FAMILIES with ADOLESCENTS
Launching children and moving on, accepting exits from and entries into the family system, development of adult- to- adult relationships between grown children and their parents
LAUNCHING FAMILY
Accepting the shifting of generational roles, maintaining own function in face of physiologic decline, support for a more central role of the middle generation, dealing with loss of spouse, siblings, peers, and preparation for own death, life review and integration
FAMILIES in LATER LIFE
Family Apgar pertaining to capability of the family to utilize and share inherent resources
ADAPTATION
Family Apgar pertaining to sharing of decision making
PARTNERSHIP
Family Apgar pertaining to physical and emotional growth
GROWTH
Family Apgar pertaining to satisfaction with emotional relationships and intimacy within the family
AFFECTION
Family Apgar pertaining to how time, space and money are shared
RESOLVE
Assesses capacity of the family’s resources and coping with crisis
SCREEM
Components of SCREEM: Factors affecting Health
SOCIAL, CULTURAL, RELIGIOUS, ECONOMIC, EDUCATIONAL, MEDICAL
Essential health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at a cost that community can afford; forms an intergral part both of the country’s health system of which it is the nucleus and of the overall social and economic development of the community
PRIMARY HEALTH CARE
Equal access to health care and Self Reliance in Health
GOALS OF PRIMARY HEALTH CARE
Elements of Primary Health Care
Education, Local/ Endemic Disease Control, EPI, Maternal and Child Health, Essential Drugs, Nutrition, Technology transfer and Sanitation
Government- Private sector partnership, Integration of preventive and curative measures, intersectoral linkages, use of village health workers, cooperation with traditional health systems, community organizing
STRATEGIES of PRIMARY HEALTH CARE
